Critical illness cover pays after an accident only when the injury matches one of the policy's named definitions, such as the loss of a hand or foot or a brain injury with lasting symptoms; a short-lived injury pays only where a policy names it. Some policies also add a fixed sum for a long hospital stay or a fracture. An FCA-authorised broker can set one insurer's injury wording beside another's, and asking for that free call-back takes the form on this page.

Which injuries from an accident do policies name?

The Association of British Insurers (ABI) says the three core conditions in every critical illness policy are cancer, heart attack and stroke. Beyond those, insurers are "not required to include any of the conditions covered in Chapter 4", so whether an accident-type injury is on the list depends on the insurer. The longer picture is on the page about which conditions critical illness cover includes.

Legal & General's direct policy terms (QGI14872 - 2026/10) name several outcomes that an accident can cause. Its words are:

Heading in the policyWhat the wording asks for
Paralysis of limb"Total and irreversible loss of muscle function to the whole of any limb."
Loss of hand or foot"Permanent physical severance of either a hand or foot at or above the wrist or ankle joints."
Traumatic brain injury"Death of brain tissue due to traumatic injury resulting in permanent neurological deficit with persisting clinical symptoms."
Third degree burns"Burns that involve damage or destruction of the skin to its full depth through to the underlying tissue and covering at least 20% of the body's surface area or covering 20% of the area of the face or head."
Blindness"Permanent and irreversible loss of sight to the extent that even when tested with the use of visual aids, vision is measured at 6/60 or worse in the better eye using a Snellen eye chart."
Deafness"Permanent and irreversible loss of hearing to the extent that the loss is greater than 70 decibels across all frequencies in the better ear using a pure tone audiogram."
Loss of speech"Total permanent and irreversible loss of the ability to speak as a result of physical injury or disease."

Several of these do not ask how the loss happened. L&G's definitions guide (QGI14860 01/26) says paralysis may be caused by injury or illness, and the speech wording covers injury or disease. The policy is testing the outcome, not whether an accident came first. For a head injury, look for the heading traumatic brain injury; the same guide gives a severe head injury caused by a road accident as its example.

How lasting does the injury have to be?

Every row above is a permanent or severe result. The traumatic brain injury wording needs permanent symptoms, and L&G's guide says the definition does not cover an abnormality seen on scans without definite related clinical symptoms. A concussion that clears, a sprain or a fracture that mends sits well short of these tests unless a policy names it. The same policy also needs the life insured to survive for 14 days from diagnosis.

Other insurers draw the line elsewhere. Vitality's Serious Illness Cover provisions (VLTD174857WF_J3779_02/2025) add a lighter traumatic brain injury entry for clinical symptoms that have lasted at least 2 weeks without needing to be permanent. It pays 10% of the cover (severity level F), a level only the 3X version of the cover reaches, and it does not cover a brain injury secondary to alcohol or drug abuse. A fracture is only paid where the wording names it, as with the same provisions' entry for surgery to correct a skull depression caused by an accidental traumatic fracture, which pays 15% (level E) on the 2X or 3X version. If an injury leaves you permanently unable to work, critical illness cover and disability explains when a disability definition applies.

Recently injured and comparing policies? Ask for injury definitions by name when the broker rings after you submit the form.

Do any policies pay for a hospital stay or a broken bone?

Some do, as add-ons that sit outside the main illness list. L&G includes an accident hospitalisation benefit with its critical illness cover. It pays £5,000 "if the life insured or relevant child is admitted to hospital with physical injuries for a minimum of 28 consecutive days immediately following an accident". The injury "must have resulted solely and directly from unforeseen, external, violent and visible means and must be independent from any other cause", only one claim is paid for each life insured, and a valid critical illness claim rules the benefit out.

Zurich handles fractures differently, as an option on its Life Protection policy (key features NP720500009 (02/25)). Multi-Fracture Cover pays either £2,000, £4,000 or £6,000 for a fracture, a dislocation, a ruptured tendon or torn ligaments, depending on where the injury is, with a maximum of £6,000 in a policy year. You choose it when the policy starts, and it cannot be added later. Injuries while taking part in or training for a listed set of sports, among them rugby, skiing and horse riding, are not paid, and neither are injuries from any sport where you are paid, or compensated in another way, to take part; professional and semi-professional sportspeople cannot claim.

What should you say about past injuries when you apply?

Under the Consumer Insurance (Disclosure and Representations) Act 2012, "it is the duty of the consumer to take reasonable care not to make a misrepresentation to the insurer". Answer the application's questions about past injuries and treatment as fully as they are asked. What an earlier injury can do to the terms offered is set out in getting life insurance with medical conditions.

Frequently asked questions

Does critical illness cover a broken bone?

Only where the policy words say so. Vitality's skull fracture surgery entry names one, and Zurich's Multi-Fracture Cover is a separate option on its Life Protection policy that does not affect the rest of the cover when claimed; the L&G injury definitions in the table turn on severe, lasting loss instead. Why claims are refused is covered in critical illness claims that are not paid.

What is critical illness accident insurance?

It is not one product. It can mean an accident benefit included with critical illness cover, such as L&G's hospital benefit, or an option such as Zurich's fracture cover. A separate accident-only policy is different again: Aviva's Signature Accidental Death Insurance pays only on a death that is "the direct result of an accident" and "is not a life, healthcare or income protection insurance policy". How that kind of cover compares with ordinary life cover is on the page about accidental death insurance, and lost earnings after an injury are covered under income protection and accident and sickness insurance.

Does critical illness cover injury as well as illness?

Not by every definition. Some, like paralysis of a limb and loss of speech in the L&G wording, cover injury or illness, while others, like traumatic brain injury and loss of a hand or foot, describe injuries. A stroke that causes paralysis is dealt with in critical illness cover and stroke.

Your own policy wording settles injury questions, and a broker, reached by the call-back form on this page, can read an actual quote through with you. The wider picture is in what critical illness cover is and the critical illness and income guide.

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